A Comparative Study on the Outcomes of Post-Placental Intrauterine Contraceptive Device Insertion Between Preterm and Term Deliveries: A Hospital-Based Observational Study

Abstract Background India is the second most populous country in the world, accounting for more than 17.8% of the global population. Family planning (FP) is one of the most effective measures for controlling population growth, as it helps in spacing and limiting unintended pregnancies and childbirths. This study aimed to compare the continuation rates and complications of post-placental intrauterine contraceptive device (IUCD) insertion following preterm versus term deliveries. Settings and Design: A hospital-based observational study. Materials and Methods A total of 2000 women were counselled for immediate postpartum IUCD insertion, of whom 240 (12%) consented and were enrolled. The study population consisted of 240 women, equally divided into term (n = 120) and preterm (n = 120) groups. In all participants, CuT 380A was inserted immediately post-placentally after obtaining informed consent. Continuation, satisfaction, and complications were assessed at 3, 6, and 12 months. Statistical Analysis: Categorical variables were presented as numbers and percentages. The uncorrected chi-squared test was used to evaluate hypotheses, with analyses performed using SPSS version 24.0. Results The mean age of participants was 26.9 ± 3.2 years. The overall continuation rate at 6 months and 12 months was 92.5% and 74% in the term and preterm groups, respectively (p < 0.05). IUCD removal on request occurred in 1.3% at 3 months, 1.7% at 6 months, and 6.7% at 12 months across both groups. Spontaneous IUCD expulsion at 6 months was significantly higher in the preterm group (7.5%) compared to the term group (1.6%) (p < 0.05). Conclusion Immediate postpartum contraception in preterm women is particularly important, as resumption of menses and sexual activity occurs earlier compared to those delivering at term. Post-placental IUCD insertion should therefore be encouraged following preterm deliveries, given its acceptable 1-year continuation rate and minimal complications.